Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Ann Surg Oncol. 2012 Jul;19 Suppl 3:S339-46. doi: 10.1245/s10434-011-1774-4. Epub 2011 May 17.
The purpose of this study was to determine if the expression of the chemokine receptors, CXCR4 and CCR7, and the chemokine ligand, CXCL12, in completely resected colorectal cancer hepatic metastases are predictive of disease-specific survival, recurrence-free survival and patterns of recurrence.
Immunohistochemical analysis of CXCR4, CCR7 and CXCL12 expression within resected hepatic metastases was performed and correlated with clinicopathological variables, disease-specific survival, recurrence-free survival and patterns of recurrence.
Seventy-five patients who underwent partial hepatectomy with curative intent were studied. CXCR4 expression (hazard ratio [HR] 3.6, 95% confidence interval [95% CI] 1.4-9.1) and clinical risk score >2 (HR 2.3, 95% CI 1.1-4.7) were independently associated with disease-specific survival by multivariate analysis. The 5-year estimated disease-specific survival rates for positive and negative CXCR4 tumor expression were 44 and 77%, respectively (P = 0.005). CXCR4 expression (HR 2.2, 95% CI 1.2-4.2) and clinical risk score >2 (HR 1.9, 95% CI 1.1-3.4) were independently associated with recurrence-free survival by multivariate analysis. The five year estimated recurrence-free survival rates for positive and negative CXCR4 tumor expression were 20 and 50%, respectively (P = 0.004). Neither CXCL12 nor CCR7 expression in tumors predicted disease-specific survival or recurrence-free survival. Forty-nine patients (65%) developed recurrent disease after initial hepatectomy. Negative CXCR4 tumor expression was associated with favorable recurrence patterns amenable to salvage resection and/or ablation.
Negative CXCR4 expression in resected colorectal cancer hepatic metastases is independently associated with improved disease-specific and recurrence-free survival and favorable patterns of recurrence.
本研究旨在确定在完全切除的结直肠癌肝转移灶中，趋化因子受体 CXCR4 和 CCR7 以及趋化因子配体 CXCL12 的表达是否可预测疾病特异性生存、无复发生存和复发模式。
对切除的肝转移灶中 CXCR4、CCR7 和 CXCL12 的表达进行免疫组织化学分析，并将其与临床病理变量、疾病特异性生存、无复发生存和复发模式相关联。
研究共纳入 75 例接受根治性部分肝切除术的患者。多变量分析显示，CXCR4 表达（风险比 [HR]3.6，95%置信区间 [95%CI]1.4-9.1）和临床风险评分>2（HR2.3，95%CI1.1-4.7）与疾病特异性生存独立相关。CXCR4 肿瘤表达阳性和阴性的 5 年估计疾病特异性生存率分别为 44%和 77%（P=0.005）。CXCR4 表达（HR2.2，95%CI1.2-4.2）和临床风险评分>2（HR1.9，95%CI1.1-3.4）与无复发生存独立相关。CXCR4 肿瘤表达阳性和阴性的 5 年估计无复发生存率分别为 20%和 50%（P=0.004）。肿瘤中 CXCL12 或 CCR7 的表达均不能预测疾病特异性生存或无复发生存。初始肝切除术后，49 例（65%）患者发生复发性疾病。CXCR4 肿瘤表达阴性与可进行挽救性切除和/或消融的有利复发模式相关。
在切除的结直肠癌肝转移灶中，CXCR4 表达阴性与改善的疾病特异性和无复发生存以及有利的复发模式独立相关。
